Maternal Health Among 2018 Top Priorities for State Senate

Growing disparity between outcomes for white and black women also a concern for lawmakers

Maternal health is an issue that Senate Democrats are planning to make a priority in 2018, as health officials have identified that deaths among pregnant women or those giving birth have started to rise. One recent report suggests New Jersey has a maternal mortality rate nearly twice the national average.

Senate health committee chairman Joseph Vitale (D-Middlesex), said he will schedule legislative hearings on the issue early in the new session, which begins the second week of January. He wants to explore ways the state can better support pregnant women and babies in the future. (No specific date has been set.)

New Jersey has made significant progress on many public health metrics, including reducing the state’s infant mortality rate, which has declined since 2000 and remains below the national average. The state has also long been a leader in tracking maternal child health, and the Department of Health’s Maternal Mortality Review Program has assessed more than 700 cases since 1999.

Maternal mortality on rise

But maternal mortality — or women’s deaths related to pregnancy or childbirth — appear to be on the rise in the Garden State. New Jersey now ranks 19th nationwide for women and children’s health, according to the 2016 America’s Health Rankings report from the United Health Foundation. The report said the state had at least 36 maternal deaths per 100,000 live births, compared to 20/100,000 nationwide, and there were significant disparities between outcomes among white mothers and women of color.

"As one of the wealthiest states in the nation by many standards, New Jersey's standing with regard to maternal and infant health is unacceptable,” Vitale said when he announced his plans last month.

"We must examine how to address the issues that make our state an outlier when it comes to the gap between infant mortality rates for Caucasians and for African-Americans, and why women of color are dying, often times from treatable conditions, at a rate that far surpasses that of whites,” he added.

Renewed concerns

Gov.-elect Phil Murphy, a Democrat who will replace Gov. Chris Christie later this month, and the new Legislature will need to face a number of challenging healthcare policy issues, including wrestling with the impact of the federal tax bill, which eliminated the health insurance mandate and could destabilize the insurance market, according to some experts. But renewed concerns surfaced last year about the state’s maternal health outcomes, which have also become a growing focus for a number of healthcare collaborations.

The issue was the focus of an NJ Spotlight roundtable discussion last spring and prompted a series of reports by NorthJersey.com, which noted that African-American women were three times more likely to die in childbirth than white woman in the Garden State. A six-month investigation by NPR and ProPublica, published in May, explored the high rate of maternal mortality in the U.S. at large, told largely through the story of a Monmouth County nurse who bled to death after complications during her delivery.

"We cannot accept a system that produces poor health outcomes at any level. But when our state is showing drastically disparate outcomes for pregnant women and infants, something is terribly wrong,” Vitale said.

Vitale joined Sen. Teresa Ruiz (D-Essex) in December to introduce legislation to create a panel of experts, armed with subpoena power, which would go beyond the existing review process. A companion version has been sponsored by Assemblywoman Pamela Lampitt (D-Camden), Assemblyman Rag Mukherji (D-Hudson), and Assemblywoman Valerie Vainieri Huttle (D-Bergen), who has led other efforts to improve maternity care.

The 31-member commission would involve hospital and medical leaders, public health officials, OB-GYNs, nurses, and others with maternal health experience. The group would be tasked with reviewing all maternal deaths and reporting its findings to state officials and would develop a mandatory, but confidential, reporting system for all healthcare providers to ensure no incidents are overlooked.

The legislation to establish this group, the Maternal Mortality Review Commission, has yet to be granted a hearing, making it unlikely to be passed in the current session. Vitale said he is also working with Sen. Loretta Weinberg (D-Bergen), on a proposal to study infant mortality.

"As health committee chairman, these issues will be among my first priorities in the new legislative session,” Vitale said. “The Senate Health, Human Services and Senior Citizens Committee will hold hearings on these issues early in the new legislative session to make sure we are doing everything we can to make sure that women and babies in this state get the care they deserve."